Atrial septal defect is the most common congenital heart defect.

Atrial septal defect is essentially a small communication between the right and left atria of the heart that can progressively lead to right ventricular enlargement and heart failure.

The "Open Foramen Ovale", also known as PFO (Patent Foramen Ovale) is essentially a very small inter-atrial communication, i.e. a small hole between the left and right atrium. All humans without exception in fetal life have an "open foramen ovale", i.e. an interatrial communication, which is essential for fetal circulation and fetal survival.

After birth, due to the anatomical construction of the foramen ovale and the change in heart pressures, this interatrial communication normally closes automatically. In very many people, however, at least 20-25% of the population, the interatrial communication does not close completely, but a small opening remains. This patent foramen ovale is so small that the amount of blood that passes through it is minimal and does not create any burden on the circulation and the heart, i.e. it is hemodynamically insignificant.

But there are some cases, in which the foramen ovale can be responsible for a very serious problem, and then its closure is discussed. In these cases, one or more severe ischemic strokes have occurred, usually in young adults or in children, who have no other reason to have a stroke (such as arteriosclerosis in the arteries that supply the brain, i.e. the carotids, or severe arrhythmias, orendocarditis, or hypercoagulable syndromes). Embolic events today are divided into those that are transient and those that leave permanent damage. Relatively often these patients complain of frequent headaches-migraines.

Most of these patients are treated with anticoagulant drugs. The surgical treatment of the foramen ovale is performed only in exceptions, while their invasive closure takes place more and more often.

Percutaneous closure of interatrial communications and patent foramen ovale is performed as a rule under general anesthesia, but it can be done under mild sedation and local anesthesia. First, the femoral vein is punctured. The catheter is moved through the vein system into the heart and specifically to the site of the heart wall defect. The catheter is passed through the defect. At the same time there is monitoring with 2D and 3D transesophageal ultrasound or intracardiac echocardiography. When the catheter is in the correct position, one tab of the device is released, which abuts the left side of the septum, and then the second tab on the right side of the septum is released. After confirming the complete closure and good position of the device radiologically and by transesophageal/intracardiac ultrasound, the final release is made.

The duration of the operation lasts 1-2 hours and requires a one-day hospitalization, while it has a minimal rate of complications, no greater than 1% of cases.